Testosterone replacement therapy – Complete Guide.

Testosterone replacement therapy – Complete Guide.

Testosterone replacement therapy (TRT) is used for restoring optimal level of testosterone in the body, through external means. Testosterone is a hormone with a huge number of benefits. From mental health to physical health. Testosterone also determines how attractive you look. It is very important to have an optimal level of testosterone.

Saying that, we must realize, that the optimal level is different for people of different sex, age and profession too. For example, a testosterone level which is high for an old man can be seen as low T for a younger man. TRT is not for putting more artificial testosterone than is required. If done that, it can be considered in the category of steroid abuse.

Before going through TRT, you got to be sure that your testosterone level is really lower than what you should have.

This is done in two steps:

1) Check all the symptoms of low testosterone
2) Do a Blood/urine/Saliva test checking the level of testosterone

Out of the three, blood test is the most common and most reliable because blood is drawn in a controlled environment and that minimizes the chances of contaminating the sample. If both the above test indicates low t then only TRT should be considered.

But there is a problem faced by many patient who have just enough testosterone to marginally pass the blood test but not enough to support a happy and healthy life.

For example, a normal male can have testosterone in the range 270 to 1070 ng/dL, so now if a blood test of a man reveals his T level to be just 275 ng/dl, then, it will be considered normal, even if it isn’t “good enough”.

Many doctor don’t consider TRT in such cases, as the testosterone level is within the given range, set by the medication association. In such case, you can consider seeing other physicians and ask for their opinion.

Who should undergo testosterone replacement therapy?

First of all, it is generally a good habit to live life as natural as you can. So, if there is a natural way to solve a problem, then it must be used. People who are below 40, should first try all the natural testosterone restoring methods.

The method can range from what you should eat to changing your life style to increase testosterone. Just sleeping well or doing proper exercise or eating proper diet can have tremendous effect on you T level. But, before all of this you must isolate the problem (if you can), which is causing low t.

You might be surprised to know, how badly alcohol can effect you testosterone. It is one off the main cause of low testosterone. Just by quitting this habit you might rejuvenate this hormone back.

Now, there might be some situation in which, no matter how much you try, you cannot take the testosterone to an optimal level naturally. In most of the cases age is the reason or some disease. Then, you should opt for Testosterone replacement therapy.

Should a woman undergo testosterone replacement therapy?

Men have about 10 times more testosterone than woman. But, testosterone is as useful for women as it is for men.

And, testosterone deficiency can effect women badly too. Low testosterone in women can cause low libido, vaginal dryness, heart problems, fatigue, diminishing bone density etc.

Therefore, it is important that optimal level of testosterone must be restored. But, care must be taken, because an over dosage can cause facial hair growth, thickening of voice and developing of other masculine features. Hence, it is advised, you should refrain from experimenting with testosterone by yourself.

Is test for testosterone level can be done at home?

Yes, there are a number of testosterone test kit available in the market. If you are too lazy to go to a doctor or do a blood test you can buy these kits online and send a sample of your saliva to the reference directories and get the result back through mail.

Although, you can take this path, but it is lot wiser to go to a doctor. If the deficiency of testosterone is not that severe then it can be treated with mere change in life style. It is of utmost importance for you to discuss your overall diet, how much you sleep or how much you drink. Maybe the reason why you have low testosterone can be detected and need of Testosterone replacement therapy (TRT) won’t come up.

Is Testosterone replacement therapy safe?

If we talk about any drug in general, there are certain side-effects and risk factors associated to it. It totally depends on how a drug is used, whether it will be good for you or cause harm. Now, lets go back to testosterone. While treating testosterone deficiency, the physician should treat different patient differently. And, then accordingly a proper dosage should be given to the patient.

Taking testosterone without consulting a doctor is not recommended at all. It can be highly dangers and even be fatal in some instance. Most of the cases that indicates negative effects of TRT, have an untrained physician or a patient taking testosterone by himself.

Why it is important to check the overall hormonal portfolio?

First of all, there is a very strong link between different hormone. In many of these cases they are interdependent on each other. So, it is better to measure level of all the hormone to get a clearer picture. For example, a higher level of estrogen can cause low level of testosterone. In such case, treatment should be done to supress estrogen production and clearing excess estrogen from the body. If instead of doing that, more testosterone is injected to the patient it can lead to severe problems.

Why I should not do testosterone therapy by myself?

As we have discussed before, every person’s body is different and needs different dosage of testosterone. If you, without any training starts taking testosterone, there can be serious consequences to it.

Secondly, when you are on TRT, the doctor frequently monitors your testosterone level. So, if the testosterone level increases more than desired, the next dosage can be toned down accordingly. But you don’t have this facilty at home.

Thirdly, testosterone is responsible for production of RBC’s. If more than required testosterone is taken, the production of RBC’s can increase rapidly, resulting in the thickening of the blood. This can lead to artery blockage or even cardiac arrest.

Different testosterone delivery system in TRT?

There are 4 main way with which testosterone can be administered into your body:

1) Injections – You may have you visit the doctor after every couple of weeks and he/she will inject a dosage of testosterone in your body through syringe.

2) Testosterone gels – You’ll get a testosterone gel in a tube which must be applied to your skin on regular basis.

3) Testosterone patches – Testosterone patches are also known as Androderm patch. They are like nicotine patches. You have to stick those patches on your skin. These patches usually, comes in two quantity 1) 2 mg 2) 4 mg, which can be pasted on you arms/chest/thighs.

4) Testosterone pelletsTestosterone pellets are also inserted in the body with the help of injections, usually in the hips or back. Later, we talk about the advantages the pellets holds over other methods.

Which testosterone delivery system is better?

Injections vs gels

Until recently, testosterone injections were considered the main method for TRT but currently, many practitioners refrain from using injections.The reason being, when you use gel or patch, you are administering a low amount of testosterone daily into your body but when an injection is used, a tremendous amount of testosterone is injected in the body, this on addition with the natural testosterone produced by the body can cause T level to go to a dangerous levels.

Patches can be put in the same category as the gel. The problem with gel is that you might forget to apply it or the quantity may go up and down, producing a different results than desired. Another problem with the gel is, as is applied to your skin surface, you can, unintentionally rub it off on people around you. Which can be bad for them.

Gels vs. pallets

The problem with gel or patches is that on applying them your testosterone level goes up high and remains at that level practically all the time. But,naturally our testosterone level should fluctuate all the time. This makes gels/shots/patches more unnatural delivery system of testosterone. But, pallets appear more natural.

This is how it works. The capillaries around the pallets dilates when you are doing some physical work, thus more testosterone starts running through your body and when you get to rest once again the capillaries will again contract and the testosterone entering your body will again go down.

So, the fluctuation of T occur in your body as an when required. Another advantage of pallets over other delivery system is, you have don’t have to renew pallet for at least four months.

Although, gel is still a good way to administer testosterone and a great number of practitioners use it.

How much testosterone replacement therapy would cost me?

Actually, the cost of testosterone replacement therapy is totally dependent upon which delivery system you choose. Injections are way much cheaper that testosterone gels. For example, if you go for shots, it might cost you around $30-$40 per month but if you choose gels you can end with at least $150-$250 less in you wallet every month. That is why, in spite of having many disadvantages over cream, people go with shots.

Patches cost almost same as the gel. When we talk about, testosterone pellet, its advantages comes with a price and this price is pretty big one. It is even more expensive.

Are there any risk or side effects involved with the testosterone replacement therapy?

When you take anything artificial there are always some risks involved with it. Testosterone replacement is nothing different. And, the side effects related to it can be very severe. Even fatal. The chances of this thing happening totally depends upon how careful the doctor have prescribed the testosterone.

If the doctor, regulates the level of testosterone in a correct way, then its dangers reduces significantly. But, the fact is, many physicians are not well trained to handle this kind of stuff. Many cases have come to light in which patients have suffered terribly after going through testosterone replacement.

There are few cases, in which doctors, for there own benefits, prescribed medicine to their patient, even if they didn’t need it. This can lead to pretty big bad outcomes.

What happens after testosterone withdrawal?

After you withdraw from testosterone, a few weeks or a couple of months later your testosterone will come back to the level, that was before you started the treatment. After that, all the symptoms of low testosterone(low libido, muscle loss, fat gain, mood swings) will come back. And, probably few more symptoms arise.

In fact, it might happen, when you start injecting testosterone externally the ability of your body to produce testosterone gets diminished. And, after a long period when you withdraw from it, you will be left with even less testosterone than what you have started with. It all depends upon for how long have you been taking testosterone and in what quantity. Every individual is different and the effects of testosterone withdrawal can more or less severe from person to person.

Who should avoid testosterone replacement therapy?

A pregnant women should not think about taking testosterone as it can badly effect the fetus. A person with a history of heart problems is also advised to stay clear of it. Prostate cancer patient too.


If, in case, it is necessary for you to undergo testosterone replacement therapy, you must do a very thorough study about testosterone and hormone replacement. You should look for a physician, who have a long experience with testosterone replacement. If possible talk to his patients. Testosterone replacement might have its side effects but its advantages dwarf them completely.

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